The Developing World Needs Its Own Doctors

Published: May 20, 1995

To the Editor:

To many of us involved in the problems of health care delivery in developing countries, "Who Will Be the World's Doctor" (editorial, May 12) is timely. It poses the most difficult question: Who will deal with the catastrophic health problems in these countries, and how will it be accomplished? Epidemics such as the outbreak of Ebola virus in Zaire are no longer isolated problems. They are of instant world impact.

A spokesman for the World Health Organization recently said that what was needed in Zaire is a massive infusion of sterile syringes, disposable gloves and gowns, eye shields and other paraphernalia for dealing with infectious diseases. Many more doctors, nurses and ancillary health personnel are urgently required.

In many African countries the population growth exceeds 4 percent a year. There are insufficient numbers of health care workers to provide basic day-to-day services. A war or an epidemic immediately overloads the system. A majority of the rural people live their lives without ever seeing a doctor or nurse.

Ultimately the indigenous people must provide their own health care systems. Our organization, widely known as the Flying Doctors of East Africa, has been working in sub-Saharan Africa for more than 35 years developing models for health care delivery with emphasis on training indigenous health care workers. More than 95 percent of our staff of 700 in Kenya, Uganda, Tanzania, Rwanda and Somalia are African.

You set forth the problem, but do not provide a practical, long-term solution. Neither the United States nor any group of nations can be the world's doctor. What we can and should do is support the development of indigenous primary health care systems. THOMAS D. REES, M.D. BRUCE BODNER New York, May 16, 1995 The writers are, respectively, co-founder and chairman of African Medical & Research Foundation.